Healthcare Provider Details

I. General information

NPI: 1801701974
Provider Name (Legal Business Name): HARRISON CONNOR GRIFFITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 TURNPIKE ST UNIT 1
CANTON MA
02021-2700
US

IV. Provider business mailing address

1028 BROADWAY APT 1
SOMERVILLE MA
02144-1883
US

V. Phone/Fax

Practice location:
  • Phone: 617-658-5611
  • Fax:
Mailing address:
  • Phone: 562-506-6221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: